Alleviating the public health burden of hypertension: debating precision prevention as a possible solution

Glob Health Action. 2024 Dec 31;17(1):2422169. doi: 10.1080/16549716.2024.2422169. Epub 2024 Nov 11.

Abstract

Hypertension is a major global health concern, with deaths attributed to the condition expected to increase to 1.57 million by 2034, particularly affecting low-and-middle-income countries such as those within sub-Saharan Africa. Non-communicable diseases, with hypertension as a core contributor, account for 74.36% of global deaths. The burden of hypertension in sub-Saharan Africa is significant, with an estimated 10-20 million people currently affected. Systemic barriers, such as fragmented health services and socioeconomic inequalities, coupled with shifts in greater salt-intake, ultra-processed foods, more sedentary lifestyles, and overburdened healthcare services, have exacerbated elevated blood pressure and poorer management of people living with hypertension in sub-Saharan Africa. Most public health strategies focus on detecting, treating, and controlling hypertension through lifestyle modifications and medication. However, evidence suggests only 10% of population hypertension is well managed. This indicates a growing need to shift towards preventative efforts. Precision prevention, a tailored health intervention approach utilising individual and population-specific factors - genetic, environmental, and social determinants - offers a potential alternative. Precision prevention aims to deliver the right preventative measures to the right population at the right time, promising to enhance intervention efficiency and health outcomes. This paper highlights various intervention levers, including environmental, biological, and behavioural modifications, examines case studies from high-income countries, and discusses the potential for implementing precision prevention in South Africa. While precision prevention shows promise, we also discuss the significant barriers to its implementation in LMICs such as those within sub-Saharan Africa.

Keywords: Africa; Precision prevention; cardiovascular disease (CVD); epidemiology; health interventions; hypertension; preventive medicine; public health; sub-Saharan Africa.

Plain language summary

Main findings: Hypertension affects 1 billion people globally and is a significant health burden in sub-Saharan Africa, where socioeconomic and lifestyle changes have increased its prevalence.Added knowledge: Precision prevention, a tailored health intervention approach, offers potential advantages over traditional methods by targeting individual and population-specific factors.Global health impact for policy and action: Implementing precision prevention strategies can improve health outcomes and reduce the burden of hypertension in sub-Saharan Africa, necessitating policy shifts and collaborative efforts to address infrastructural and resource challenges.

MeSH terms

  • Africa South of the Sahara / epidemiology
  • Cost of Illness
  • Global Health
  • Humans
  • Hypertension* / prevention & control
  • Life Style
  • Precision Medicine
  • Public Health*
  • Socioeconomic Factors

Grants and funding

The author(s) reported that there is no funding associated with the work featured in this article.